Endoscopic surgical stapling instrument with pivotable and rotatable staple cartridge

• US 5,381,943 A
• Filed: 10/09/1992
• Issued: 01/17/1995
• Est. Priority Date: 10/09/1992
• Status: Expired due to Term

• Current Assignee: Ethicon Incorporated (Johnson & Johnson)
• Original Assignee: Ethicon Incorporated (Johnson & Johnson)
• Inventors: Allen, Eugene D., Hibner, John A., Ortiz, Mark S., Bedi, James J., Conlon, Sean P., Burdorff, Mark A., Bishop, Gregory D., Paraschac, Joseph, Hughett, J. David, Sierocuk, Thomas J., Smith, Jack E., Sambi, Narinderjit
• Primary Examiner(s): Rada, Rinaldi I.
• Application Number:
  US07/959,184
• Time in Patent Office: 830 Days
• Field of Search: 227/175, 227/176, 227/177, 227/178, 227/179, 227/180, 227/19
• US Class Current: 227/177.1
• CPC Class Codes: A61B 17/0682 for applying U-shaped staples or clamps, e.g. without a forming anvil
• CPC Class Codes: A61B 17/0684 having a forming anvil staying above the tissue during stapling
• CPC Class Codes: A61B 17/3421 Cannulas
• CPC Class Codes: A61B 2017/2903 transferring rotary motion
• CPC Class Codes: A61B 2017/2923 Toothed members, e.g. rack and pinion
• CPC Class Codes: A61B 2017/2927 the angular position of the head being adjustable with respect to the shaft
• CPC Class Codes: A61B 2017/2929 with a head rotatable about the longitudinal axis of the shaft

Abstract

A surgical stapler is provided which is insertable through an endoscopic tube to enable a surgeon to staple a hernia patch to tissue inside a body cavity. The endoscopic surgical stapler includes a staple cartridge pivotally mounted on the distal end of a support tube extending from a handle provided with an actuator mechanism for actuating a staple forming mechanism inside the staple cartridge to fasten staples to the tissue. The staple cartridge is adjustable to different angular orientations relative to the support tube. The staple actuator mechanism is operable to actuate the staple cartridge in any of the angular orientations. The support shaft is rotatable about its longitudinal axis relative to the handle to adjust the rotational orientation of the support shaft and the staple cartridge. The staple cartridge is rotatable about its longitudinal axis relative to the support shaft to adjust the rotational position of the staple cartridge relative to the support shaft. Separate actuator mechanisms are provided on the handle to control the pivotal movement of the staple cartridge, the rotation of the support shaft, and the rotation of the staple cartridge relative to the support shaft.

Claims

1. A surgical stapling instrument for applying one or more surgical staples to tissue, said instrument comprising:

a handle including a staple actuator mechanism;

an elongated tubular support shaft having a longitudinal axis and extending from said handle, said support shaft being mounted to said handle and having a rotating mechanism controlling rotation about said longitudinal axis relative to said handle;

a staple cartridge mounted at the distal end of said support shaft for holding a plurality of staples and including a staple forming mechanism connected to said staple actuator mechanism for applying the staples to the tissue;

pivot means at the distal end of said support shaft for mounting said staple cartridge for pivotal movement about an axis transverse to said longitudinal axis of said support shaft and which includes actuator means on said handle for pivoting said staple cartridge about said transverse axis to adjust the angular position of said staple cartridge relative to said support shaft; and

an articulation driver slidably mounted for longitudinal movement in said support shaft for connecting said actuator means to said pivot means to pivot said staple cartridge relative to said support shaft, said articulation driver including a guide pin at its distal end received in an arcuate groove in said pivot means for converting the longitudinal movement of said articulation driver into pivotal movement of said staple cartridge relative to said support shaft.

2. An endoscopic surgical stapling instrument for applying one or more surgical staples to internal body tissue comprising:

an actuator handle assembly including a staple actuator mechanism;

an elongated tubular support shaft having a longitudinal axis and extending from said actuator handle assembly, said support shaft being mounted to said actuator handle assembly and including a shaft rotation mechanism controlling rotation of said shaft about its longitudinal axis relative to said actuator handle assembly;

a staple cartridge mounted at the distal end of said support shaft for holding a plurality of staples and including a staple forming mechanism connected to said staple actuator mechanism for applying the staples to the tissue, said staple cartridge having a circumferential cross-section no greater than said shaft cross-section;

pivot means at the distal end of said support shaft for mounting said staple cartridge for pivotal movement relative to said support shaft about an axis transverse to said longitudinal axis of said support shaft;

cartridge rotating means for rotating said staple cartridge relative to said support shaft about a cartridge axis defined along the length of said cartridge;

staple driver means drivingly engaged with said staple actuator mechanism for being operated by said staple actuator mechanism when said staple cartridge is at any angular position relative to said shaft, said staple driver means comprising;

a staple driver suitably mounted for longitudinal movement in said support shaft and coupled to said staple actuator mechanism; and

a plunger slidably mounted on said pivot means and actuated by the longitudinal movement of said staple driver for actuating the staple forming mechanism when said staple actuator mechanism is operated.

3. The stapling instrument of claim 2, which includes:

a pivot link for connecting said plunger to said staple driver to permit said staple forming mechanism to pivot relative to said staple driver.

4. The stapling instrument of claim 2, wherein:

said plunger is coupled to said staple forming mechanism for longitudinal movement therewith and is adapted to permit said staple forming mechanism to rotate about the longitudinal axis of said staple cartridge relative to said plunger.

5. An endoscopic surgical stapling instrument for applying one or more surgical staples to internal body tissue comprising:

an actuator handle assembly including a staple actuator mechanism;

an elongated tubular support shaft having a longitudinal axis and extending from said actuator handle assembly, said support shaft being mounted to said actuator handle assembly and including a shaft rotation mechanism controlling rotation of said shaft about its longitudinal axis relative to said actuator handle assembly;

a staple cartridge mounted at the distal end of said support shaft for holding a plurality of staples and including a staple forming mechanism connected to said staple actuator mechanism for applying the staples to the tissue, said staple cartridge having a circumferential cross-section no greater than said shaft cross-section;

pivot means at the distal end of said support shaft for mounting said staple cartridge for pivotal movement relative to said support shaft about an axis transverse to said longitudinal axis of said support shaft;

cartridge rotating means for rotating said staple cartridge relative to said support shaft about a cartridge axis defined along the length of said cartridge;

actuator means on said handle assembly for pivoting said staple cartridge relative to said support shaft about said transverse axis; and

an articulation driver slidably mounted for longitudinal movement in said support shaft for connecting said actuator means to said pivot means to pivot said staple cartridge relative to said support shaft, said articulation driver including a guide pin at its distal end received in an arcuate groove in said pivot means for converting the longitudinal movement of said articulation driver into pivotal movement of said staple cartridge relative to said support shaft.

6. An endoscopic surgical stapling instrument for applying one or more surgical staples to internal body tissue comprising:

an actuator handle assembly including a staple actuator mechanism;

an elongated tubular support shaft having a longitudinal axis and extending from said actuator handle assembly, said support shaft being mounted to said actuator handle assembly and including a shaft rotation mechanism controlling rotation of said shaft about its longitudinal axis relative to said actuator handle assembly;

a staple cartridge mounted at the distal end of said support shaft for holding a plurality of staples and including a staple forming mechanism connected to said staple actuator mechanism for applying the staples to the tissue, said staple cartridge having a circumferential cross-section no greater than said shaft cross-section;

pivot means at the distal end of said support shaft for mounting said staple cartridge for pivotal movement relative to said support shaft about an axis transverse to said longitudinal axis of said support shaft;

cartridge rotating means for rotating said staple cartridge relative to said support shaft about a cartridge axis defined along the length of said cartridge;

actuator means on said handle assembly for pivoting said staple cartridge relative to said support shaft about said transverse axis;

an articulation driver slidably mounted for longitudinal movement in said support shaft for connecting said actuator means to said pivot means to pivot said staple cartridge relative to said support shaft;

said actuator means comprising;

a slide member mounted for longitudinal movement on said actuator handle assembly; and

a coupling member for connecting said slide member to said articulation driver for transmitting the longitudinal movement of said slide member to said articulation driver to pivot said staple cartridge.

7. The stapling instrument of claim 6, wherein:

said articulation driver is free to rotate relative to said slide member.

8. A surgical stapling instrument for applying one or more surgical staples to tissue, said instrument comprising:

a handle including a staple actuator mechanism;

a tubular support shaft having a longitudinal axis and a circumferential cross-section and extending from said handle;

a staple cartridge carried on said support shaft and connected to said staple actuator mechanism for applying one or more staples seriatim to the tissue, said staple cartridge when mounted on said shaft having a circumferential cross-section no greater than said shaft cross-section;

a pivot connection structure connecting said said staple cartridge to said support shaft for accommodating pivotal movement of said cartridge about an axis transverse to said longitudinal axis of said support shaft;

a pivot actuator located on said handle and operative to effect the pivoting of said staple cartridge; and

cartridge rotating means on said shaft for rotating said staple cartridge relative to said support shaft about a cartridge axis defined along the length of said cartridge;

said pivot connection structure including a pivotable housing that is pivotable relative to said support shaft;

said staple cartridge being mounted to said pivotable housing for rotation about said cartridge axis,

said staple cartridge including a hollow cartridge housing containing a staple advancing and forming mechanism operatively connected to said staple actuator mechanism, said staple advancing and forming mechanism including a former that is longitudinally reciprocatable within said hollow cartridge housing; and

said former having a proximal end for rotatably engaging said staple actuator mechanism to accommodate rotation of said former about the cartridge axis relative to said support shaft and said staple actuator mechanism.

9. A surgical stapling instrument for applying one or more surgical staples to tissue, said instrument comprising:

a handle including a staple actuator mechanism;

a tubular support shaft having a longitudinal axis and a circumferential cross-section and extending from said handle;

a staple cartridge carried on said support shaft and connected to said staple actuator mechanism for applying one or more staples seriatim to the tissue, said staple cartridge when mounted on said shaft having a circumferential cross-section no greater than said shaft cross-section;

a pivot connection structure connecting said staple cartridge to said support shaft for accommodating pivotal movement of said cartridge about an axis transverse to said longitudinal axis of said support shaft;

a pivot actuator located on said handle and operative to effect the pivoting of said staple cartridge; and

cartridge rotating means on said shaft for rotating said staple cartridge relative to said support shaft about a cartridge axis defined along the length of said cartridge;

said pivot connection structure including a pivotable housing that is pivotable relative to said support shaft;

said staple cartridge being mounted to said pivotable housing for rotation about said cartridge axis,

said staple cartridge including a hollow cartridge housing containing a staple advancing and forming mechanism operatively connected to said staple actuator mechanism, said staple advancing and forming mechanism including a former that is longitudinally reciprocatable within said hollow cartridge housing; and

said instrument further including a retainer having

(A) a proximal end received in said pivotable housing to accommodate rotation of said retainer relative to said pivotable housing; and

(B) a distal end received in said hollow cartridge housing with a latch to prevent relative rotation between said retainer and said hollow cartridge housing.

10. A surgical stapling instrument for applying one or more surgical staples to tissue, said instrument comprising:

a handle including a staple actuator mechanism;

a tubular support shaft having a longitudinal axis and a circumferential cross-section and extending from said handle;

a staple cartridge carried on said support shaft and connected to said staple actuator mechanism for applying one or more staples seriatim to the tissue, said staple cartridge when mounted on said shaft having a circumferential cross-section no greater than said shaft cross-section;

a pivot connection structure connecting said staple cartridge to said support shaft for accommodating pivotal movement of said cartridge about an axis transverse to said longitudinal axis of said support shaft;

a pivot actuator located on said handle and operative to effect the pivoting of said staple cartridge; and

cartridge rotating means on said shaft for rotating said staple cartridge relative to said support shaft about a cartridge axis defined along the length of said cartridge;

said staple cartridge including a cartridge housing that contains a staple storage, advancing, and forming system and a plurality of staples each having

(A) a generally U-shaped body including a crown with a central offset portion between two non-offset portions;

(B) a pair of legs at opposite ends of said crown depending from said non-offset portions, said staples being arranged in a side-by-side stack oriented transversely to the cartridge axis with the staple legs oriented perpendicularly to the cartridge axis; and

said staple storage, advancing, and forming system including a staple advancing and forming mechanism that is operatively engaged with said staple actuator mechanism and that is adapted for engaging the distalmost staple to advance the distalmost staple distally to effect engagement of part of said staple crown with a part of said cartridge housing whereby the staple rotates about ninety degrees to an orientation with the staple legs oriented parallel to the cartridge axis.

11. A surgical stapling instrument for applying one or more surgical staples to tissue, said instrument comprising:

a handle including a staple actuator mechanism;

a tubular support shaft having a longitudinal axis and a circumferential cross-section and extending from said handle;

a staple cartridge carried on said support shaft and connected to said staple actuator mechanism for applying one or more staples seriatim to the tissue, said staple cartridge when mounted on said shaft having a circumferential cross-section no greater than said shaft cross-section;

a pivot connection structure connecting said staple cartridge to said support shaft for accommodating pivotal movement of said cartridge about an axis transverse to said longitudinal axis of said support shaft;

a pivot actuator located on said handle and operative to effect the pivoting of said staple cartridge; and

cartridge rotating means on said shaft for rotating said staple cartridge relative to said support shaft about a cartridge axis defined along the length of said cartridge;

said staple cartridge including a hollow cartridge housing containing a plurality of staples and a staple advancing and forming mechanism for moving one of said staples toward the distal end of said cartridge and forming the staple;

each said staple having a generally U-shaped body including a crown with a central offset portion between two non-offset portions and a pair of legs at opposite ends of said crown each depending from one of said non-offset portions; and

said staple cartridge housing including;

a staple storage region defined by a guide surface for supporting and guiding said staple crowns and includes a cavity for receiving said staple legs, said staples being arranged in a side-by-side stack in said storage region with each staple oriented transversely to the cartridge axis with the staple legs oriented perpendicularly to the cartridge axis;

a staple feeder shoe in said storage region and a spring biasing said feeder shoe distally along the length of said cartridge to engage the most proximal staple in said stack and urge said stack distally;

an inclined surface and an inclined ramp spaced from said inclined surface for receiving therebetween the distalmost staple from the stack at the distal end of said guide surface, said inclined surface and ramp each being oriented at an oblique angle relative to said cartridge axis; and

spaced-apart extension surfaces for receiving said staple crown as said staple advances distally from said inclined surface and inclined ramp whereby either said offset portion or said non-offset portions engage said ramp to rotate said staple about 90°

into an orientation with the staple legs oriented parallel to said cartridge axis and pointing toward the distal end of said, cartridge.

12. An endoscopic surgical stapling instrument for applying one or more surgical staples to internal body tissue, said instrument comprising:

an actuator handle assembly including a staple actuator mechanism;

an elongated tubular support shaft having a longitudinal axis and extending from said actuator handle assembly, said support shaft being mounted to said actuator handle assembly and including a first rotation mechanism controlling rotation of said shaft about its longitudinal axis relative to said actuator handle assembly;

a staple cartridge mounted at the distal end of said support shaft for holding a plurality of staples and including a staple forming mechanism connected to said staple actuator mechanism for applying the staples to the tissue;

pivot means at the distal end of said support shaft for mounting said staple cartridge for pivotal movement relative to said support shaft about an axis transverse to said longitudinal axis of said support shaft;

a second rotation mechanism controlling rotation of said cartridge about its longitudinal axis relative to said pivot means and to said support shaft;

actuator means on said handle assembly for pivoting said staple cartridge relative to said support shaft about said transverse axis; and

an articulation driver slidably mounted for longitudinal movement in said support shaft for connecting said actuator means to said pivot means to pivot said staple cartridge relative to said support shaft, said articulation driver including a guide pin at its distal end received in an arcuate groove in said pivot means for converting the longitudinal movement of said articulation driver into pivotal movement of said staple cartridge relative to said support shaft.

13. An endoscopic surgical stapling instrument for applying one or more surgical staples to internal body tissue, said instrument comprising:

an actuator handle assembly including a staple actuator mechanism;

an elongated tubular support shaft having a longitudinal axis and extending from said actuator handle assembly, said support shaft being mounted to said actuator handle assembly and including a first rotation mechanism controlling rotation of said shaft about its longitudinal axis relative to said actuator handle assembly;

a staple cartridge mounted at the distal end of said support shaft for holding a plurality of staples and including a staple forming mechanism connected to said staple actuator mechanism for applying the staples to the tissue;

pivot means at the distal end of said support shaft for mounting said staple cartridge for pivotal movement relative to said support shaft about an axis transverse to said longitudinal axis of said support shaft;

a second rotation mechanism controlling rotation of said cartridge about its longitudinal axis relative to said pivot means and to said support shaft;

actuator means on said handle assembly for pivoting said staple cartridge relative to said support shaft about said transverse axis; and

an articulation driver slidably mounted for longitudinal movement in said support shaft for connecting said actuator means to said pivot means to pivot said staple cartridge relative to said support shaft, said articulation driver including at its distal end one of a guide pin and arcuate groove, said pivot means including the other of said guide pin and arcuate groove, said guide pin being received in said arcuate groove for converting the longitudinal movement of said articulation driver into pivotal movement of said staple cartridge relative to said support shaft.